Clinical significance of assessing ADAMTS-13 and von Willebrand factor level in COVID-19 convalescent pregnant women

Autor: N. R. Gashimova, K. N. Grigoreva, V. O. Bitsadze, L. L. Pankratyeva, J. Kh. Khizroeva, M. V. Tretyakova, Ya. M. Shammut, E. Iu. Iupatov, V. I. Tsibizova, J.-K. Gris, D. V. Blinov, A. D. Makatsariya
Jazyk: ruština
Rok vydání: 2023
Předmět:
Zdroj: Акушерство, гинекология и репродукция, Vol 17, Iss 1, Pp 8-17 (2023)
Druh dokumentu: article
ISSN: 2313-7347
2500-3194
DOI: 10.17749/2313-7347/ob.gyn.rep.2023.386
Popis: Introduction. Coronavirus infection is associated with severe endotheliopathy, thromboinflammation and immunothrombosis leading to excessive release of von Willebrand factor (vWF) multimers from Weibel–Palade bodies, which can affect activity of ADAMTS-13 metalloproteinase (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13) and the ADAMTS-13/vWF axis previously shown by us to be altered in non-pregnant women with severe COVID-19. Aim: to study a clinical role of hemostasis activation particularly ADAMTS-13/vWF axis in pregnant women after COVID-19. Materials and Methods. A prospective case–control study was conducted with pregnant women (n = 135) divided into 3 groups: group 1 included 45 women with prior COVID-19 during pregnancy, group 2 – 45 women in the acute phase of the infection during pregnancy, group 3 – 45 healthy pregnant women. The level of vWF and ADAMTS-13 was assessed in all patients. Results. The concentration of vWF antigen (vWF:Ag) in the acute period of the disease in pregnant women with COVID-19 was significantly higher compared to the control group (p < 0.001). ADAMTS-13 level in pregnant women after COVID-19 did not differ from that of in control group, while vWF level was significantly higher in 66.7 % (30/45). The ADAMTS-13/vWF ratio was increased and significantly differed both in pregnant patients during the acute period of the disease (p < 0.001) and pregnant women after infection (p = 0.0002) compared with the control group. Conclusion. Our results show that endotheliopathy was prominently manifested in pregnant women with COVID-19 and persisted for several months after disease. The ADAMTS-13/vWF ratio determines the pathway functioning, the risk of microcirculation disorders and clinical complications.
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